Individual
SIMMON L WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4550 E CHARLESTON BLVD, LAS VEGAS, NV 89104-5525
(702) 415-9906
(866) 383-4399
Mailing address
6421 ABERDEEN LN, LAS VEGAS, NV 89107-1268
(702) 415-9906
(866) 383-4399
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2009007880
MO
207QA0505X
Adult Medicine Physician
11588
NV
207QA0505X
Adult Medicine Physician
6968998-1205
UT
207QA0505X
Adult Medicine Physician
MD033724E
PA
208VP0000X
Pain Medicine Physician
Primary
11588
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000185023
HIGHMARK BC/BS
PA
05
—
100510116
—
NV
Enumeration date
04/17/2006
Last updated
02/24/2014
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